A Comprehensive Community-Based Approach to Serving Students with Emotional and Behavioral Disorders

Abstract

Recent reports about the mental health status of children and adolescents with emotional and behavioral disorders, the limited availability of related services, and a lack of collaborative practices indicate a need to consider how services are provided to these individuals and their families. In this paper, the needs of this population and the costs of providing services are presented. Then the issues that are essential to developing a comprehensive, community-based approach to serving students with emotional and behavioral disorders are discussed.

Shifting from categories to services: Comprehensive school‐based mental health for children with emotional disturbance and social maladjustment

“…The school-based mental health model also supports intensive case management, which requires careful monitoring of the services that are provided, and done so by a single case manager for the duration of needed services. This ensures that the delivery of services is integrated and meets the changing needs of the child and the child's family (Epstein et al, 1993). Within a school-based mental health care model, detailed collaborative relationships need to be mutually established at the outset along with careful monitoring of the effectiveness of that collaboration.…”

“…Collaboration among the various agencies and stakeholders in establishing procedures, responsibilities, and financing based on the needs of community members is critical for successful implementation of comprehensive school-based mental health services (Epstein et al, 1993). It is important that schools not only collaborate with social service agencies, but families as well.…”

‘And what about residential…?’ Re‐conceptualizing residential treatment as a stop‐gap service for youth with emotional and behavioral disorders

“…In the past 20 years, admissions to RTCs specializing in treating youths with EBD have approximately doubled (Manderscheid & Sonnenshein, 1994;Tuma, 1989;Yelton, 1993), with the most recent report showing a 1998 year-end total of 30 370 youths across 462 RTCs nationally (U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, 2000). Several factors have contributed to this influx, including: (i) an increasing prevalence of youths with EBD (Epstein et al, 1993;Walker, Colvin, & Ramsey, 1995); (ii) national and regional thrusts for de-institutionalization, which, in addition to promoting community-based treatment, have shifted children from psychiatric in-patient facilities to less restrictive residential facilities (Spreat & Jampol, 1997); and (iii) the increasing numbers of Juvenile Justice referrals, especially of very young offenders (Snyder, Espiritu, Huizinga, Loeber, & Petechuk, 2003).…”

“…family relative, foster care, treatment foster care). In addition, as part of a comprehensive treatment plan, the intensive case manager brokers necessary services from other community agencies, monitors plan effectiveness, and helps to adapt services to the families' changing needs (Epstein et al, 1993). One example of the latter for RTCs with an adjunct treatment foster care program may include securing a periodic respite placement for the youth when additional, or more intensive, work with the family becomes necessary (Chamberlain, 1994;President's New Freedom Commission on Mental Health, 2003).…”

“…The goal of ICM is the provision of individualized services to youth and their families, tailoring those services to the specific needs of the child (Epstein et al, 1993). The RTC intensive case manager is a team member, trained in social learning principles, who serves as the lead consultant to the youth's discharge family (biological or foster).…”